ASA: Periodontal Disease Tied to Large-Artery Atherothrombotic Stroke

WEDNESDAY, Feb. 12, 2020 — Periodontal disease (PD) is associated with large-artery atherothrombotic stroke, including stroke due to intracranial atherosclerosis (ICAS), and people with gingivitis are more likely to have ICAS, according to two studies scheduled to be presented at the American Stroke Association International Stroke Conference, held from Feb. 19 to 21 in Los Angeles.

Rachel Mascari, from the University of South Carolina School of Medicine in Columbia, and colleagues assessed PD in 265 consecutive patients with ischemic stroke and transient ischemic attack, 87 of whom had PD. Twenty percent of the strokes were caused by large-artery atherothrombosis. The researchers found that within this group, the proportion of patients with PD was higher than those without PD (24 versus 12 percent). Patients with PD also had a significantly higher proportion of stroke due to posterior circulation disease (12 versus 5 percent; crude odds ratio, 3.0; adjusted odds ratio, 3.1) and a significantly increased rate of stroke due to ICAS (20 versus 8 percent; crude odds ratio, 2.6; adjusted odds ratio, 2.6).

In a second study, Mascari and colleagues collected full-mouth clinical periodontal measurements at six sites per tooth from 6,155 participants in the Dental Atherosclerosis in Communities Study. The researchers found that participants with gingivitis had significantly higher odds of having ≥50 percent ICAS compared with participants without gum disease (crude odds ratio, 2.1). After adjustment for age, hypertension, and low-density lipoprotein cholesterol, the association was strengthened (adjusted odds ratio, 2.4).

“We are working on a current study to evaluate if treatment of gum disease can reduce its association with stroke,” a coauthor said in a statement.

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